Sensitivity and Specificity Analysis of Fine Needle Aspiration Cytology (FNAC) for Thyroid Swelling.

Introduction Thyroid gland disorders, such as goiters or tumor masses, are the result of localized or systemic aberrations of the thyroid gland. The purpose of this research was to see how effective fine needle aspiration cytology (FNAC) was in detecting thyroid swelling in patients with thyroid swelling. It is critical to be able to differentiate between benign and malignant thyroid nodules to reduce unnecessary thyroid surgeries. It is hypothesized that FNAC is not a reliable diagnostic tool to detect thyroid nodules in patients with thyroid swelling and that there is a significant variation between the number of thyroid nodules detected by FNAC and the number of thyroid nodules that were eventually diagnosed as malignant by surgery. The significance of this research shows the effectiveness of diagnostic tests for thyroid nodules in patients with thyroid swelling can help reduce unnecessary surgeries and improve patient care. Methods This cross-sectional study was carried out at the Department of Pathology at a tertiary care hospital in central India, from March 1, 2022 to June 31, 2022. Fifty patients with thyroid swelling were covered in the study. All patients were chosen after an ultrasound revealed goiter on clinical grounds. Results The majority of patients in the age group 31-40 years (33.33%) were female (74.67%). About 54.67% of the patients had a single thyroid nodule. FNAC had a sensitivity of 95.38%, a specificity of 53.33%, a positive predictive value of 86.67% and a negative predictive value of 88.57%. Conclusion FNAC is a simple, economical, and commonly used first-line diagnostic method for thyroid cancer. A false negative or false positive cytological diagnosis may be produced as a result of thyroid cytology. The study emphasizes the need to improve basic healthcare in rural India by treating FNAC as a first-line diagnostic test for thyroid swellings to guide management, although it does not replace histopathology.

Optimized, simple and selective analytical tool for determination of carcinogenic aniline in wastewater.

Here, we explored a low-cost, rapid, sensitive, and selective practical approach to manifest carcinogenic anilines by using oxone as an oxidant to mitigate its presence in wastewater. The calibration curves for OAP & PAP indicate reasonable sensitivity, percent recovery & correlation in the range 2.18-9.28 µg/mL. The Sandell's sensitivity for OAP & PAP was found to be 0.010-0.018 & 0.009-0.018 µg/mL, respectively. The range of correlation coefficient 0.979 to 0.998 shows the involvement of high precision and perfect correlation of the data. Values of coefficient of determination (r2) denote the change in absorbance or (dA/dt)i or kobs by 95.8-99.6%. The percent recovery was found to be 98.05-99.91% for six parallel determinations. Furthermore, we also analyzed some wastewater samples to further validate the proposed method. The reproducible results, good percent recovery, and reasonable sensitivity proposed a feasible approach for the estimation of aminophenol in wastewater.

Connexin 43-mediated neurovascular interactions regulate neurogenesis in the adult brain subventricular zone.

The subventricular zone (SVZ) is the largest neural stem cell (NSC) niche in the adult brain; herein, the blood-brain barrier is leaky, allowing direct interactions between NSCs and endothelial cells (ECs). Mechanisms by which direct NSC-EC interactions in the adult SVZ control NSC behavior are unclear. We found that Cx43 is highly expressed by SVZ NSCs and ECs, and its deletion in either leads to increased NSC proliferation and neuroblast generation, suggesting that Cx43-mediated NSC-EC interactions maintain NSC quiescence. This is further supported by single-cell RNA sequencing and in vitro studies showing that ECs control NSC proliferation by regulating expression of genes associated with NSC quiescence and/or activation in a Cx43-dependent manner. Cx43 mediates these effects in a channel-independent manner involving its cytoplasmic tail and ERK activation. Such insights inform adult NSC regulation and maintenance aimed at stem cell therapies for neurodegenerative disorders.

A Review of Machine Perfusion Strategies in Liver Transplantation.

The acceptance of liver transplantation as the standard of care for end-stage liver diseases has led to a critical shortage of donor allografts. To expand the donor organ pool, many countries have liberalized the donor criteria including extended criteria donors and donation after circulatory death. These marginal livers are at a higher risk of injury when they are preserved using the standard static cold storage (SCS) preservation techniques. In recent years, research has focused on optimizing organ preservation techniques to protect these marginal livers. Machine perfusion (MP) of the expanded donor liver has witnessed considerable advancements in the last decade. Research has showed MP strategies to confer significant advantages over the SCS techniques, such as longer preservation times, viability assessment and the potential to recondition high risk allografts prior to implantation. In this review article, we address the topic of MP in liver allograft preservation, with emphasis on current trends in clinical application. We discuss the relevant clinical trials related to the techniques of hypothermic MP, normothermic MP, hypothermic oxygenated MP, and controlled oxygenated rewarming. We also discuss the potential applications of ex vivo therapeutics which may be relevant in the future to further optimize the allograft prior to transplantation.

Hypertension medication from guidelines to practice: A cohort study in western Iran.

PURPOSE: Hypertension (HTN) is one of the most common risk factors for non-communicable chronic diseases. The aim of the current study is to evaluate the prescribing patterns of antihypertensive medications in Kermanshah Province, west of Iran. METHODS: The Ravansar Non-Communicable Diseases (RaNCD) cohort study is the first Kurdish community-based study; subjects' age ranged from 35 to 65 years. In order to examine the use of medications to control blood pressure, participants were asked to bring all prescribed medications to the study center. Treatments were compared with 2013 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) Guidelines for the management of arterial HTN. RESULTS: From a total of 10 040 participants in RaNCD cohort, 1575 (15.7%) individuals were hypertensive, of whom, 1271 (80.7%) people were aware of their condition. From 1153 (73.20%) people under treatment, 840 (72.8%) had their HTN properly controlled. The most common medications used to treat HTN were losartan (27.5%), metoprolol (14.3%), and captopril (11.9%). Regardless of type of treatment, 49.3% of all patients have received the medication for l 6 ≥ years. The most commonly used drugs were ß-blockers and angiotension receptor blockers as 620 (31.0%) and 612 (30.6%), respectively. Multivariable analysis showed that female gender, those receive ≥3 antihypertensive agents, and using preferred combinations were associated with a better blood pressure control. In addition, the probability of hypertension control was less likely with increasing duration of treatment (i.e >6 years) and in obese patients with ≥35 kg/m2 . CONCLUSIONS: Even though adherence to the international guidelines was acceptable, improvements can be made for better control of HTN. Therefore, it is imperative to educate healthcare professionals on improving their selection of antihypertensive medications and combination therapy for hypertensive patients.

Quantitative Automated Segmentation of Lipiodol Deposits on Cone-Beam CT Imaging Acquired during Transarterial Chemoembolization for Liver Tumors: A Deep Learning Approach.

PURPOSE: To show that a deep learning (DL)-based, automated model for Lipiodol (Guerbet Pharmaceuticals, Paris, France) segmentation on cone-beam computed tomography (CT) after conventional transarterial chemoembolization performs closer to the "ground truth segmentation" than a conventional thresholding-based model. MATERIALS AND METHODS: This post hoc analysis included 36 patients with a diagnosis of hepatocellular carcinoma or other solid liver tumors who underwent conventional transarterial chemoembolization with an intraprocedural cone-beam CT. Semiautomatic segmentation of Lipiodol was obtained. Subsequently, a convolutional U-net model was used to output a binary mask that predicted Lipiodol deposition. A threshold value of signal intensity on cone-beam CT was used to obtain a Lipiodol mask for comparison. The dice similarity coefficient (DSC), mean squared error (MSE), center of mass (CM), and fractional volume ratios for both masks were obtained by comparing them to the ground truth (radiologist-segmented Lipiodol deposits) to obtain accuracy metrics for the 2 masks. These results were used to compare the model versus the threshold technique. RESULTS: For all metrics, the U-net outperformed the threshold technique: DSC (0.65 ± 0.17 vs 0.45 ± 0.22, P < .001) and MSE (125.53 ± 107.36 vs 185.98 ± 93.82, P = .005). The difference between the CM predicted and the actual CM was 15.31 mm ± 14.63 versus 31.34 mm ± 30.24 (P < .001), with lesser distance indicating higher accuracy. The fraction of volume present ([predicted Lipiodol volume]/[ground truth Lipiodol volume]) was 1.22 ± 0.84 versus 2.58 ± 3.52 (P = .048) for the current model's prediction and threshold technique, respectively. CONCLUSIONS: This study showed that a DL framework could detect Lipiodol in cone-beam CT imaging and was capable of outperforming the conventionally used thresholding technique over several metrics. Further optimization will allow for more accurate, quantitative predictions of Lipiodol depositions intraprocedurally.

Hydrophobically modified cotton fabric assisted separation of oil-water mixture.

Superhydrophobic-superoleophilic fabrics were prepared and evaluated for oil-water mixture separation efficiencies. The nano-TiO2 and nano-SiO2 based coatings were done on the surface of the cotton fabric to create nanoscale roughness over the surface which was further modified by low energy material 1, 1, 3, 3-Hexamethyldisilazane (HMDS) and, polydimethylsiloxane (PDMS). Particle size and stability of prepared sol were characterized by particle size analysis and zeta potential. Coated cotton fabric samples were characterized by contact angle, contact angle hesteresis and surface free energy for its hydrophobic nature. Surface morphology was studied by scanning electron microscopy (SEM). The coated fabrics were found to be hydrophobic with low surface free energy values. The maximum contact angle was found to be 133° and lowest contact angle hysteresis was 5°. SEM confirmed the appearance of nanoscale surface roughness after coating of sols on cotton fabric. The average particle size and zeta potential values of silica sol was 61 nm and 137 mv whereas for titania sol it was found 344 nm and 200 mv, respectively. The oil-water separation efficiency of coated fabric was also observed by a different oil-water mixture. The coatings were found to be hydrophobic in nature and seem to be very useful for oil-water mixture separation.

Determinants of curative resection in incidental gallbladder carcinoma with special reference to timing of referral.

BACKGROUNDS/AIMS: Re-resection of incidental gallbladder carcinoma (IGBC) is possible in a select group of patients. However, the optimal timing for re-intervention lacks consensus. METHODS: A retrospective analysis was performed for a prospective database of 91 patients with IGBC managed from 2009 to 2018. Patients were divided into three groups based on the duration between the index cholecystectomy and re-operation or final staging: Early (E), < 4 weeks; Intermediate (I), > 4 weeks and < 12 weeks; and Late (L), > 12 weeks. Demographic data, tumor characteristics, and operative details of patients were analyzed to determine factors affecting the re-resectability of IGBC. RESULTS: Twenty-two patients in 'E', 48 in 'I', and 21 in 'L' groups were evenly matched. Nearly two thirds were asymptomatic. Curative resection was possible in 48 (52.7%) patients. Metastasis was detected during staging laparoscopy (SL)/laparotomy in 26 (28.6%) patients. The yield of SL was more in the 'L' group (30.8%) than in the 'I' (11.1%) or 'E' (nil) group, avoiding unnecessary laparotomy in 13.6%. Only 28.5% of patients in the 'L' group could undergo curative resection (R0/R1 resection), significantly less than that in the 'E' (50.0%) or 'I' group (64.6%) (both p < 0.001). On multivariate analysis, presentation in intermediate period and tumor differentiation increased the chance of curative resection (p < 0.05). CONCLUSIONS: Asymptomatic patients in the 'I' group with well differentiated IGBC have the best chance of obtaining a curative resection.

Use of Artificial Intelligence in Non-Oncologic Interventional Radiology: Current State and Future Directions.

The future of radiology is disproportionately linked to the applications of artificial intelligence (AI). Recent exponential advancements in AI are already beginning to augment the clinical practice of radiology. Driven by a paucity of review articles in the area, this article aims to discuss applications of AI in non-oncologic IR across procedural planning, execution, and follow-up along with a discussion on the future directions of the field. Applications in vascular imaging, radiomics, touchless software interactions, robotics, natural language processing, post-procedural outcome prediction, device navigation, and image acquisition are included. Familiarity with AI study analysis will help open the current 'black box' of AI research and help bridge the gap between the research laboratory and clinical practice.

Multifaceted Roles of Connexin 43 in Stem Cell Niches.

PURPOSE OF REVIEW: Considerable progress has been made in the field of stem cell research; nonetheless, the use of stem cells for regenerative medicine therapies, for either endogenous tissue repair or cellular grafts post injury, remains a challenge. To better understand how to maintain stem cell potential in vivo and promote differentiation ex vivo, it is fundamentally important to elucidate the interactions between stem cells and their surrounding partners within their distinct niches. RECENT FINDINGS: Among the vast array of proteins depicted as mediators for cell-to-cell interactions, connexin-comprised gap junctions play pivotal roles in the regulation of stem cell fate both in vivo and in vitro. SUMMARY: This review summarizes and illustrates the current knowledge regarding the multifaceted roles of Cx43, specifically, in various stem cell niches.

nspA gene as a specific genetic marker for detection of Neisseria meningitidis causing bacterial meningitis.

Bacterial meningitis caused by Neisseria meningitidis which causes human brain meninges damage, is generally diagnosed from patient cerebrospinal fluid through microscopy, immunological assays, biochemical test, PCR, microarray and biosensors. However, these methods are expensive, time-consuming or non-confirmatory due to certain limitations. A quick PCR based method was developed for detection of bacterial meningitis caused by N. meningitidis using specific primers based on amplification of virulence nspA (Neisseria surface protein A) gene partial sequence (202 bp). The nspA gene amplicon could be used as a genetic marker for minimum detection of 10 ng genomic DNA (G-DNA) of N. meningitidis with high sensitivity only in 80 min, which is least time reported for the confirmation of the disease. However, the lower detection limit was found as low as 1.0 ng G-DNA, but with less sensitivity. The cross-reactivity of the genetic marker, was also studied with other possible pathogens. A comparison with the presently available detection methods and our method was also done using patient samples.

Coupling of algal biofuel production with wastewater.

Microalgae have gained enormous consideration from scientific community worldwide emerging as a viable feedstock for a renewable energy source virtually being carbon neutral, high lipid content, and comparatively more advantageous to other sources of biofuels. Although microalgae are seen as a valuable source in majority part of the world for production of biofuels and bioproducts, still they are unable to accomplish sustainable large-scale algal biofuel production. Wastewater has organic and inorganic supplements required for algal growth. The coupling of microalgae with wastewater is an effective way of waste remediation and a cost-effective microalgal biofuel production. In this review article, we will primarily discuss the possibilities and current scenario regarding coupling of microalgal cultivation with biofuel production emphasizing recent progress in this area.

Generalized idiopathic root resorption: a case report.

BACKGROUND: Cases of generalized idiopathic root resorption have been reported in the literature. However the majority of previously reported cases have affected adults, and it has been rare that a possible link to a medical condition has been found. CASE REPORT: The subject of this case report was 11 years old when generalized root resorption was first diagnosed. This case report is unusual in that the resorption may be connected to a bone dysplasia. The possible medical diagnoses and links to tooth resorption have been discussed for this very rare case. CONCLUSION: The investigation into the exact diagnosis of the patient and the treatment of tooth resorption is still ongoing and has required input from many disciplines of Medicine and Dentistry.